Journal of Microbiology and Related Research

Roseomonas gilardii is gram negative pink pigmented non fermentive bacteria and has been responsible for rare cause of human infections. The bacterium considered in recent years to be uncommon, yet potentially of clinical importance as an opportunistic pathogen mostly in patient with underlying disease particularly malignancy. We reported the case of Catheter related blood stream infection in African patient who is on chemotherapy with underlying malignancy. The organism was initially identified by phenotypical characterization and confirmed by 16S RNA gene sequence analysis. Very few such cases had been reported in India.

Keyword: Catheter Related Blood Stream Infection; Roseomonas Gillardi. 

Introduction: Ocular cysticercosis is a parasitic infection caused by larvae of Taenia solium. Occurring in 10-30% of the infected patients in endemic areas and may be extraocular or intraocular. It is one of the neglected tropical diseases. It may cause significant visual loss if not treated in time. Here we report three cases of ophthalmic cysticercosis in school going children, all of whom were vegetarian by diet. Each case was unique representing different clinical features and treatment requirements. Case Series: Case 1: A five year old school going female presented with painless nodular swelling in her left eye for 3months. On examination, she had a sub conjunctival nodule measuring 7mm x 6mm, about 3mm nasal to the limbus. Her radiological findings revealed a well-defined cystic lesion with well-defined eccentric hyperintensity suggestive of extraocular cysticercosis. Patient underwent surgical excision of the cyst, histopathological examination of which showed features of cysticercosis cellulosae. Case 2: A fourteenyear- old male presented with nodular painless swelling in the lateral aspect of the left eye since 8 years. Ocular examination revealed swelling measuring 13mm x 11mm about 6mm temporal to limbus. Clinical and radiological findings were suggestive of sub conjunctival cysticercosis. Patient was taken for surgical excision of the cyst. Histopathological examination revealed cyst of Taenia solium confirming the diagnosis of extraocular cysticercosis left eye infiltrating lateral rectus muscle. Case 3: An eleven-year-old girl, vegetarian by diet presented with complaints of blurred vision and floaters in right eye for 3 weeks. On retinal examination, a single translucent vitreous cyst was found which on ultrasound scans had features suggestive of intravitreal cysticercosis. Patient was taken up for pars plana vitrectomy for the removal of the cyst, which was removed piecemeal. Conclusion: Ocular cysticercosis, a neglected parasitic disease is nowa- days emerging as a common disease in the tropics. The diagnosis is mainly based on clinical features and radiology. Consciousness about importance of early diagnosis, appropriate surgical management and medical management with appropriate anthelminthic drugs should be increased among clinicians with community and personal hygiene measures for prevention of its spread.

Keywords: Ocular Cysticercosis; School-Going Children; Eye Disease. 

Context: Number of blind people in the world is 45 million. Out of which 5.4 million blind people are in India. Corneal Ulcer is a major cause of blindness throughout the world. About 10% cases of blindness are due to Corneal Ulcer. Corneal Ulcers can be caused by exogenous infections i.e. by viruses, bacteria, fungi or parasites and sometimes it is allergic in nature or it can be due to endogenous infections. Actinomycosis is a rare cause of ulcerative keratitis. Objective: To isolate and identify Actinomyces from Corneal Ulcer and study their susceptibility and resistance pattern with various antibiotics. Materials and Methods: A total of 100 samples were collected during period of June 2014 to March 2015 from ophthalmology hospital, government hospital and clinical laboratories. Samples were collected in sterile container containing 0.5ml of Brain Heart Infusion Broth (BHI) as enrichment culture medium that supports the growth. Isolation of Actinomycetes has been done by using several selective media. Their identification was confirmed by Morphological, Biochemical and Cultural characteristics. After identification Actinomycetes species were subjected to antibiotic resistance and sensitivity pattern have been carried out by using disc diffusion technique. Results: The results of present study show that Vancomycin is 100% resistant to Actinomycetes and Ciprofloxacin, Ofloxacin were effective against Actinomycetes species in the treatment of severe Actinomycosis. Conclusion: Ciprofloxacin and Ofloxacin for the initial empirical treatment of Actinomycosis is a good option. Prompt diagnosis of corneal ulcers and treatment with appropriate antibiotics prevent blindness and devastating visual disability.

Keywords: Antibiotic Resistance; Corneal Ulcer; Actinomycetes.

Introduction: The incidence of superficial mycosis in patients with human immunodeficiency virus (HIV) is increasing in India. Aims and objectives: 1. To determine the prevalence, clinical variations, common aetiological agents of superficial mycoses and its CD4 count in HIVpositive subjects in our area. Methods and Material: A study was carried out among 150 HIV positive patients over a period of 18 months. Clinical observations were followed by conventional laboratory methods for diagnosis of aetiological fungal species. Results: The number of patients 62/150 (41.3%) had at least one superficial mycosis. Dermatophytosis (64.71%) was the commonest presentation followed by onychomycosis (26.47% ). The two sites involvement was seen in 9.67% followed by (2.94%) patients each with extensive tinea corporis and tinea versicolor. The fungal species isolated were T. rubrum (35.29%), T. mentagrophyte (10.29%), T. verrucosum (2.94%), T. tonsurans (2.94%), T. schonlenii (1.47%) and M. canis (1.47%). Non-dermatophytes identified were Candida spp. (8.82%), Scopulariopsis spp. (5.88%), Fusarium spp. (1.47%) and Malassezia spp. (2.94%). Only one isolate of Sporothrix sckenskii was isolated. Statistical analysis: by using statistical package for social sciences (SPSS) software. Conclusions: In majority of patients, the clinical presentations did not differ from those found in immunocompetent individuals. We found nondermatophytic onychomycosis and atypical presentations which is rare in immunecompetent patients. We found no increased incidence of superficial mycosis with decreased CD4 count.

Keywords: CD4 Count; HIV; Superficial Mycosis. 

Introduction: About 75% of the mortality associated with burn injuries is related to sepsis, especially in developing countries. Since it is desirable to carry out periodic reviews of bacterial flora of burn wounds and environmental surveillance to look for possible sources of wound contamination, so that preventive strategies could be modified as necessary; present study has been carried out. Aims & Objectives: To identify the pathogens causing hospital acquired infections in burn units and determines their antimicrobial resistance pattern. Also to assess & correlate the environmental conditions and risk factors associated with burn infections. Setting and Design: Observational study done in rural tertiary care centre for duration of two years. Materials & Methods: Patients with Total burn surface area (TBSA)>10% were enrolled in study excluding children less than 12 years of age. From patient; surface wound swab, normal skin swab, nasal swab and throat swab were collected on first, third, seventh, tenth, and fourteenth day post admission. Environmental sampling was done every three months. Result: Out of 112 patients included in study, 62 were infected with burn wound infections. Colonization rates were 62% on third day, 77% on 14th day. Rates of invasive infections were 4% on third day increasing to 61% on 14th day. Overall, Pseudomonas aeruginosa was the predominant isolate (28%) followed by Staphylococcus aureus (23%), Klebsiella pneumoniae (11%), Coagulase Negative Staphylococcus (CONS) (9%) & Acinetobacter species (9%). High level of environmental contamination was seen with Pseudomonas aeruginosa. Conclusion: The most common route of infection was cross-infection.

Keywords: Burn Wound Infections; Colonisation; Environmental Surveillance; Health Care Workers. 

Context: Staphylococcus is a gram-positive, non-motile, nonsporing bacteria that include different opportunistic pathogenic species, responsible for human and animal infections. Aims: To isolate and identify Staphylococcus aureus from different human clinical samples and to determine various virulence factors of these isolates. Settings and Design: Prospective study conducted in Dept of Microbiology, SKIMS J&K. Methods and Material: Various clinical samples eg pus, blood, sputum etc received in the Microbiology laboratory were processed for isolation of Gram positive cocci. Identification of Staphylococcus aureus was done by standard microbiological methods and various virulence factors were determined. Statistical Analysis Used: Descriptive statistics (frequency and percentage) was used. Results: A total of 217 strains of Staphylococcus aureus were isolated from 1100 clinical specimens. All the isolates had ability to produce free and bound coagulase enzyme. Out of 217 strains, 42 (19.35%)strains showed only  hemolysin production, 84 (38.70%) strains showed only  hemolysin production and rest 91(41.93%) strains showed both  and hemolysin production. Among all the strains, 203 (93.54%) were positive for producing biofilm and rest of 13 were negative for producing biofilm. Out of 217 strains of S.aureus only 49 (22.58%) strains were able to produce the staphyloxanthin pigment and rest 168 (77.41%) were found to be negative. All strains of S.aureus were sensitive to Linezolid, Teicoplanin and vancomycin. On the other hand strains showed high resistance towards Cefoxitin (65.89%). Conclusions: Prevalence of methicillin rsistance was high in IPD setting (65.89%) and production of various virulence factors like coagulase, hemolysin production, biofilm production and staphyloxanthin pigment production was more common in MRSA than in MSSA thus suggesting that infection control policies should be adhered positively.

Keywords: Staphylococcus Aureus; Prevelance; Virulence Factors. 

Background: Many automated urine analysers like IRIS IQ 200 and IChem Velocity (Beckman coulter) performing automated biochemical and microscopic examination are now available to improve the accuracy and productivity of urine examination and minimize the inter observer variability. It has been especially useful in predicting the growth of microorganisms in urine culture thereby reducing the time from diagnosis to initiation of treatment. Objective: The present study was undertaken to evaluate the role of fully automated Iris IQ200 and IChem velocity workstation (Beckman Coulter) in predicting urine infections and those needing culture. Materials and Methods: A total of 252 patients coming to our diagnostic centre for urine examination from January to August 2017 were included in the study.Urine was inoculated on blood and McConkey Agar plates with a 0.01 ml calibrated loop and after incubating at 370C for 24 hours, bacterial growth and colony identification was carried out by standard protocol. A significant growth was considered with a colony count of 104 CFU/ml. Results: Leucocyte esterase was positive in 82 (32.5%) cases, nitrite in 23 (9.12%), bacteria in 72 (28.5%) and bacterial growth in culture in 99 (39.2%) patients. Out of these insignificant growth was seen in 22 (22.23%) and significant growth in 77 (77.77%). Out of 99 cases which showed bacterial growth in culture, E.coli was grown in 70 cases with 56 patients showing significant colony count. Klebsiella sps was grown in 21 cases, Enterococcus and Enterobacter sps in three cases, Pseudomonas in two cases. Conclusion: Automated urine analysers are good predictors of urine cultures and UTI and have enhanced accuracy due to reporting of leucocyte esterase, nitrite, bacteria and all small particles.

Keywords: iQ 200; iChem Velocity; ASP; Leukocyte Esterase; Nitrite. 

Background: P. aeruginosa is the most common nosocomial pathogen encountered and a known organism causing high mortality and morbidity. Due to indiscriminate antibiotic use, resistance is very commonly known in them and ESBL enzyme production being the most predominant one. Material and Methods: A total of Ninty isolates of P. aeruginosa were tested for the presence of ESBL enzyme by both disc diffusion and double disc synergy test. Antibiotic sensitivity pattern of ESBL-positive P. aeruginosa was determined. Results: Of the 1200 pus samples screened, 90 isolates of pseudomonas were tested for ESBL production. Of the 90 P.aeruginosa isolates, 57 (63%) were sensitive to 3GC and 33 (37%) were resistant.Of the 33 P.aeruginosa resistant to ceftazidime, DDT detected 9 (27%) of ESBL producers and DDST detected 17 (51%). And 17 (51%) did not show ESBL production by either of the methods used in the study. All the ESBL-positive P. aeruginosa were multi-drug resistant, with 100% sensitivity to imipenem; followed by ofloxacin (70%). Conclusion: From this study, we conclude that DDST proved to be better method than DDT to detect ESBL producing P. aeruginosa. However in the absence of any CLSI guidelines for detection of ESBL in Non-fermenters, we reframe from commenting on specificities of either of tests. There is a strong need for standardization/ CLSI guidelines for detection.

Keywords: Third Generation Cephalosporins; Double Disk Synergy Test; Disc Diffusion Test; P. Aeruginosa. 

Introduction: Coagulase negative staphylococci are important causative agents of 10% of pyogenic infections in hospitals, which include a range of infections like surgical wound sepsis, bacteremia, native valve endocarditis (NVE) and prosthetic valve endocarditis, osteomylitis, pyoarthritis, peritonitis, mediastinitis, prostatitis, infection of vascular grafts and pacemakers. Materials and Methods: 105 samples are collected from infected post operative cases, infected burns, infected wounds from traumotology unit, diabetic foot, gangrene, nonhealing ulcers, pyoderma, and impetigo, patients with intravenous cannulae. Results: of 105 samples tested 50 (47.61%) of CNS are isolated, Out of 50 isolates of Coagulase negative staphylococci 24 (48%) isolates were identified as S. epidermidis. Out of 34 community isolates, 13 (38.23%) were sensitive to Penicillin and. 11(61.76%) were resistant 13 (75.47%) were sensitive to Oxacillin and 3(13.23%) were resistant. Conclusion: In the present study CNS was the most predominant organism (105/50; 47.61%). Most of CNS isolates were from the hospital infections (68%). Coagulase negative Staphylococci have been increasingly gaining importance in hospital infections, compared to E. coli, Klebsiella, MRSA and Pseudomonas. Majority of the isolates were from IV catheters (76.19%), stressing the need for more aseptic precautions in ICU settings.

Keywords: I.V.; MRSA; CNS. 

Introduction: Urinary tract infections (UTI) are the most common infections in clinical practice. They can have serious complications on maternal and fetal outcome when they occur in pregnancy. Screening all pregnant women for significant bacteriuria can prevent the complications of UTI in pregnancy. Aims and Objectives: To studythe bacterial profile of urinary tract infections and the antimicrobial susceptibility patterns among pregnant women. Material and Methods: This was a prospective hospital basedstudy carried out in the Department of Microbiology, Deccan College of Medical Sciences, Hyderabad, Telangana, over a one year period from April 2016 to March 2017. Results: A total of 235 urine samples were received from pregnant women and processed in Microbiology laboratory. 110 urine samples showed significant bacteriuria. The most commonly isolated bacteria were E. coli 80 (72.7%), K. pneumoniae 7 (6.3%), S. aureus 13 (11.8%), P. aeruginosa 5(4.5%), Coagulase negative staphylococci 5(4.5 %). Conclusion: This study showed that prevalence of UTI in pregnant women was 36.2%. It was also observed that E. coli (72.7%) was the most frequently isolated bacteria. All pregnant women should be screened for UTI with a urine culture and treated with antibiotics if the culture is positive.

Keywords: Urinary Tract Infection; Pregnancy; Urine Culture Antimicrobial Susceptibility. 

Introduction: Currently antibiotic resistance in bacterial populations is one of the greatest challenges to the effective management of infections. Infections caused by Pseudomonas aeruginosa are frequently life threatening & difficult to treat as it exhibits intrinsically high resistance to many antimicrobials & the development of increased, particularly multi-drug resistance in health care settings. Objective: The present study was done to determine the drug sensitivity pattern of Pseudomonas aeruginosa from various clinical specimens in our set up. Materials and Method: This study was conducted during October 2015 to May 2016. A total of 376 strains of Pseudomonas aeruginosa were isolated from various clinical specimens. Pseudomonas aeruginosa was identified by using standard microbiological techniques. Antimicrobial susceptibility patterns of all the isolates were carried out by Kirby- Bauer disk diffusion method as per CLSI guidelines. Result: A total 376 strains of Pseudomonas aeruginosa were isolated of which 267 (71%) were from indoor & 109 (29%) were from outdoor patients. Of the 376 isolates 206 were from males & 170 were from females. Majority of isolates of Pseudomonas aeruginosa were obtained from specimens of pus. Majority of the strains showed low level of susceptibility to Ceftazidime (38%), Ofloxacin (40.4%), Ciprofloxacin (42.1%), Piperacillin (47.7%) & Gentamicin (51%). We got good sensitivity with Tobramycin (82.1%) & with Amikacin (78.3%). All isolates were susceptible to Imipenem (100%). Conclusion: The result of our study suggests the occurrence of resistant strains of Pseudomonas aeruginosa. Periodic susceptibility testing should be carried out over a period of two to three years to detect the resistance trends & judicious, rational treatment regimen prescription should be followed by physician.

Keywords: Antibiotic Susceptibility Pattern; Pseudomonas aeruginosa. 

Context: Hepatitis B Virus infection is one of a serious public health problem worldwide and it is 50±100 times more contagious than HIV. Many of the carriers do not realize that they are infected with the virus rendering the HBV to be known as a “silent killer”. The transmission of hepatitis B virus (HBV) is parenteral, sexual and perinatal. Prevention of vertical transmission of HBV is extremely important, because HBV infection in early life usually results in a chronic carrier state. Aim: To study the prevalence of Hepatitis B surface Antigen (HBsAg) positive among pregnant women referred to Department of Microbiology, Karnataka Institute of Medical Sciences during the study period. Materials and Methods: The study is a prospective study conducted by collecting blood samples from 3223 antenatal women with age ranging from 21-30 years, attending the department of Microbiology during the study period. Screening of HBs Ag was done by rapid immunochromatographic method. Results: Out of 3223 antenatal women screened 48 were positive accounting for 1.49%. In the age group of 21-25 years 34 (1.45%), 26-30 years 13 (1.92%) and 31-35 years one (0.5%) antenatal women were positive The highest prevalence was observed in the age group 26- 30 years (1.92%). Conclusion: HBV during pregnancy is associated with a high risk of maternal complications, has a high rate of vertical transmission. The study suggests expansion of the Hepatitis B vaccination program to reduce the risk of HBV among pregnant women.

Keywords: Hepatitis B Virus; Antenatal Women; HBsAg; Universal Immunisation Programme. 

Introduction: Acute otitis media (AOM) is a common condition with a high morbidity and low mortality. Acute suppurative otitis media (ASOM) is termed as the rapid and short onset of signs and symptoms of inflammation in the middle ear. It generally affects younger age group,with signs: otalgia, otorrhoea, fever, etc. bacterial profile of ASOM is clinically very important for accurate treatment. Material & Methods: Present study was carried in Department of Microbiology during the period September 2006 to August 2008 at Government College and Hospital, Ambajogai. A total of 179 clinically diagnosed cases of otitis media were included in study in the present study. A pretested proforma was filled in each case noting particulars in each case. Patients with ear discharge from acute otitis media with or without complications were selected, indoor as well as outdoor patients with discharging ears, had not received treatment for at least seven days prior to taking the samples. Results: Of the 179 swabs of ASOM, 162 swabs were culture positive (90.50%). Aerobes were isolated from 146 swabs (81.56%). Streptococcus pneumoniae was commonest isolate, 28 (18.79%). Anaerobes were isolated from 4 swabs (2.23%).Prevotella melaninogenica was predominant isolate, 2 (50%). Conclusions: ASOM is a common ENT condition with high morbidity and in our study a total of 179 cases were recorded with features of ASOM. More than 90% of samples were culture positive which was comparable to results by other authors. Aerobes were isolated in more than 80% of cases and Streptococcus pneumoniae was being comment organism.

Keywords: ASOM; Otitis Externa; Bacteriological Profile; Ear Discharge; Aerobes; Anaerobes. 

Introduction: Coagulase negative staphylococci (CoNS), which are the normal skin flora, have emerged as predominant pathogens in hospital-acquired infections. More than 30 species of CoNS are recognized but only a few are commonly incriminated in human infections. CoNS species identification, which is still difficult for most clinical laboratories, is necessary in order to establish epidemiological trends, confirm treatment failures and to determine the cause of specific infections. Recently use of broad-spectrum antibiotics for treatment of CoNS leads to increase in the development of antibiotic resistance. Therefore the present study was conducted to identify frequency of CoNS species isolated from various clinical specimens and determination of their antimicrobial susceptibility pattern. Material and Method: Prospective study included a total of 238 non duplicate coagulase negative staphylococci from various clinical specimens. The specimens were collected using strict aseptic precautions and transported immediately to the laboratory. All the specimens received were processed further for identification by standard microbiological procedures [17]. Qualitative data were compared with the Chi-Square or Z test as appropriate. Results: Predominant species isolated in our study was S. epidermidis (42.02%) followed by S. haemolyticus (21.43%) and S. saprophyticus (15.13%). Majority of CoNS species were isolated from pus sample with the exception of S. saprophyticus which was more commonly isolated from urine. Majority of CoNS isolates were resistant to penicillin followed trimethoprim/ sulfamethaxazole and tetracycline and all isolates were sensitive to vancomycin, teicoplanin and linezolid. In our study, 58.82% species of CoNS were methicillin resistant. Antimicrobial resistance to most of the commonly used antibiotics was more among methicillin resistant CoNS as compared to methicillin sensitive and the difference was statistically significant. Conclusion: The increased recognition of pathogenic potential of CoNS and emergence of drug resistance among them warrants the need to identify various species of CoNS and determine their antibiotic resistance pattern.

Keywords: CoNS; S. Epidermidis; S. Saprophyticus; MRCoNS. 

Ultrasonography machines are ideal vectors for cross infections. A busy machine may be used to scan many patients a day. The infections can be transmitted via ultrasound probes & coupling gel. Klebsiella species are frequent cause of infection in both community & Hospital. Klebsiella isolated from US probe is an important nosocomial pathogen & infections due to it are difficult to manage due to resistance to multiple antibiotics. So this study aimed to determine the percentage ESBL producing Klebsiella species isolated from US probes & to determine the antibiotic sensitivity pattern.

Keywords: Ultrasonography; US Probes; ESBL.